Tracheostomy Care with a Cuffless Tracheostomy Tube

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There are several kinds of tracheostomy (tray ke OS toe me) tubes. The type of tracheostomy (trach) tube your child has depends on the reason he needs the trach.

A child on an assisted breathing device (ventilator or BiPAP machine) may have a trach tube without a cuff. Uncuffed tubes usually slide in and out very easily. Uncuffed tubes come in several sizes: neonatal, pediatric, and adult. The neonatal tubes are for young infants. Pediatric tubes are for toddlers and young children. Neonatal and pediatric tubes are single-cannula tubes. Adult trach tubes are usually for the older child, adolescent, or adult.

All trach tubes have an obturator (Picture 1). Use the obturator only to insert the trach tube into the child’s trachea. It helps the trach tube go in easier. After the trach tube is in place, take out the obturator right away.

Cuffless trach tube with obturator.


  • 2 Tracheostomy tubes: Same size and one size smaller
  • Water- based lubricant
  • Trach ties

How to Change a Cuffless Tracheostomy Tube

  1. Wash hands
  2. Gather supplies
  3. Inspect the tracheostomy tube
  4. Put the obturator into the tracheostomy tube
  5. Apply the lubricant to the tip of the trach tube
  6. Attach trach tie to tube (optional)
  7. Remove the old trach tie
  8. Take out the old trach tube
  9. Insert the new trach tube and immediately remove the obturator
  10. Secure the trach ties

Disposable vs. Reusable Tubes

A cuffless trach tube may be thrown away after use or used again.  Check the package insert to see if it can be cleaned and reused.

Most trach tubes are disposable.  They are used for one month.  A new trach tube is then put in and the old one is thrown away.  This prevents infection and plugging of the tube. Shiley trachs are disposable.

Some brands of trach tubes, such as Bivona, are reusable.  The trach is still changed every month.  It is then removed, cleaned and sterilized again for the next time.  If your child is using one of these tubes, the nurse will teach you how to clean, sterilize, and store your child’s trach tube.

Other Information

  • There should be an air leak around the tracheostomy tube.
  • Secretions may come out around the trach tube.
  • See Helping Hands HH-II-99, Stoma Care; HH-II-191, Care Of An Inner Cannula; and HH-II-203, Reusable Tracheostomy Tubes for more information

Tracheostomy Care with a Cuffless Tracheostomy Tube (PDF)

HH-II-202 5/12, Reviewed 11/17 Copyright 2012, Nationwide Children's Hospital